University of Cambridge, Cambridge, United Kingdom.
University of Oxford, Oxford, United Kingdom.
J Clin Oncol. 2021 Jan 10;39(2):145-154. doi: 10.1200/JCO.20.00596. Epub 2020 Dec 10.
A first-in-human study was performed with MP0250, a DARPin drug candidate. MP0250 specifically inhibits both vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) with the aim of disrupting the tumor microenvironment.
A multicenter, open-label, repeated-dose, phase I study was conducted to assess the safety, tolerability, and pharmacokinetics of MP0250 in 45 patients with advanced solid tumors. In the dose-escalation part, 24 patients received MP0250 as a 3-hour infusion once every 2 weeks at five different dose levels (0.5-12 mg/kg). Once the maximum tolerated dose (MTD) was established, 21 patients were treated with a 1-hour infusion (n = 13, 8 mg/kg, once every 2 weeks and n = 8, 12 mg/kg, once every 3 weeks) of MP0250 in the dose confirmation cohorts.
In the dose-escalation cohort, patients treated with 12 mg/kg MP0250 once every 2 weeks experienced dose-limiting toxicities. Therefore, MTD was 8 mg/kg once every 2 weeks or 12 mg/kg once every 3 weeks. The most common adverse events (AEs) were hypertension (69%), proteinuria (51%), and diarrhea and nausea (both 36%); hypoalbuminemia was reported in 24% of patients. Most AEs were consistent with inhibition of the VEGF and HGF pathways. Exposure was dose-proportional and sustained throughout the dosing period for all patients (up to 15 months). The half-life was about 2 weeks. Signs of single-agent antitumor activity were observed: 1 unconfirmed partial response with a time to progression of 23 weeks and 24 patients with stable disease, with the longest duration of 72 weeks and a median duration of 18 weeks.
MP0250 is a first-in-class DARPin drug candidate with suitable tolerability and appropriate pharmacokinetic properties for further development in combination with other anticancer therapies.
进行了一项首个人体研究,评估了候选药物 MP0250 的安全性、耐受性和药代动力学。MP0250 特异性抑制血管内皮生长因子 (VEGF) 和肝细胞生长因子 (HGF),旨在破坏肿瘤微环境。
一项多中心、开放性、重复剂量、I 期研究,评估了 45 例晚期实体瘤患者接受 MP0250 的安全性、耐受性和药代动力学。在剂量递增部分,24 例患者以 3 小时输注,每 2 周一次,在 5 个不同剂量水平(0.5-12mg/kg)下接受 MP0250 治疗。一旦确定最大耐受剂量(MTD),21 例患者在剂量确认队列中接受 1 小时输注(n=13,8mg/kg,每 2 周一次,n=8,12mg/kg,每 3 周一次)的 MP0250 治疗。
在剂量递增队列中,接受 12mg/kg MP0250 每 2 周一次治疗的患者出现剂量限制毒性。因此,MTD 为 8mg/kg 每 2 周一次或 12mg/kg 每 3 周一次。最常见的不良反应(AE)为高血压(69%)、蛋白尿(51%)、腹泻和恶心(均为 36%);24%的患者出现低白蛋白血症。大多数 AE 与 VEGF 和 HGF 通路的抑制一致。在所有患者中,暴露量呈剂量比例且在整个给药期间持续(最长 15 个月)。半衰期约为 2 周。观察到单药抗肿瘤活性的迹象:1 例未经确认的部分缓解,进展时间为 23 周,24 例患者病情稳定,最长持续时间为 72 周,中位持续时间为 18 周。
MP0250 是一种首创的 DARPin 候选药物,具有适宜的耐受性和适当的药代动力学特性,可与其他抗癌疗法联合开发。